Printed fromJewishRobbinsville.com

Educate your child... educate a generation!

ב"ה

Registration

We are currently accepting application forms for the upcoming school year. Please fill out ALL fields of this form. If you have any questions or concerns you'd like to discuss with us, please contact us at 609-838-0008
Please note that one registration form per child is needed.
We look forward to a wonderful year of learning and growth.
Tuition Cost is $600 per child.
Student Profile
Full Name:*
First NameLast Name
Hebrew Name:*
DOB:*
MonthDayYear
Grade Entering:*
School:*
Allergies If any, please explain:
Emergency Information
Doctor’s Name:*

Doctor's Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Medical Conditions If any, please explain:
Emergency Contact Other Than Parent:*
Phone Number*
Area CodePhone Number
CONFIDENTIAL: Does your child have any allergies or other medical condition we should be aware of? If yes, please describe them and indicate special precautions or care needed:
Is the natural mother of the child Jewish?*
YesNo
Any adoptions or conversions in the family?*
YesNo
If Yes, Please Explain:
What goals do you have for your child attending Hebrew School?*
Hebrew Reading Proficiency:*
NoneSomewhatWell
Previous Jewish Education:*
YesNo
Where?
Name of Sibling:
Birth Date of Sibling:
MonthDayYear
Name of Sibling:
Birth Date of Sibling:
MonthDayYear
Name of Sibling:
Birth Date of Sibling:
MonthDayYear
Parent Information
Father's Name:*
First NameLast Name
Phone Number:*
Area CodePhone Number
Mother's Name:*
First NameLast Name
Phone Number:*
Area CodePhone Number
If no please explain:

Address:*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's email:*
Mother's email:*
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of the Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, the Chabad Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in the Chabad Hebrew School activities and that these pictures may be used for marketing purposes.
*
I hereby give permission for my child to be photographed. Photos may be used for promotional purposes for Chabad of Robbinsville.
Full Name of Parent:*
First NameLast Name
Initials:*
Payment Information
Your application is not complete without a payment plan. Chabad Hebrew School does not reject anyone due to lack of funds. If you feel that you need a special payment plan please call our office at 609-838-0008. Tuition Cost is $600 per child.
Payment options:*
Pay in full - $600Payment plan. Please note registration is not complete until your payment plan has been confirmed.
Total
$0.00

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

*Disclaimer*
Acceptance and attendance of the Noah Tedrus Chabad Hebrew School is completely independent from the Chabad Bar/Bat Mitzva program. There is a separate registration and acceptance process for this, please reach out for details.
Should be Empty:

This page uses TLS encryption to keep your data secure.